Medicare for all — Now!

(6/7/2017)

From: Mark L. Martin, D.O.

As a practicing physician,the Affordable Care Act was not what I wanted, but like many I felt it was a first step forward. I expected the overall plan would evolve and improve over time. The idea was that by using private insurance backed by government subsidies and mandated coverage, eventually everyone would become insured at an affordable rate.

Now we are seeing the wholesale sell out of our health care to the insurance companies from both the federal level (AHCAITrumpcare) and in our own state of Minnesota. Our state legislators first spent over $300 million to buy down the increased premiums of the insurance companies for 2017. Then they allotted $540 million for a “reinsurance” program to protect the insurance companies from losing money over the next two years. Who knew so many sick people would actually use the insurance once they were able to afford it?? They also discarded the idea of a public option for a Minnesota Care buy in for all Minnesotans regardless of income. All this money and protections for the insurance companies that increased deductibles and premiums in the first place with no guarantees that premiums will go down or the quality of the insurance will go up in 2018.

Then our legislature proposed a budget that would cut up to $500 million from Health and Human Services. This department funds Minnesota Care and medical assistance programs for health care coverage for children, the disabled, and low-income people. Then, our legislators decided to allow for-profit insurance companies to enter the health care marketplace. Currently the nonprofit HMOs that are contracted to run the state’s programs hold public assets of around $10 billion in assets and reserves. If these companies decide to become for-profit insurance companies, are there any protections for our public assets? It looks like the insurance companies did well by our legislators this session. Not so well for the average working people! Funny thing, the nonprofit HMOs have taken billions of dollars in tax money to administer the state programs, but have never been audited.

On the federal level, as a practicing physician in the area of rehabilitation medicine, the AHCAITrumpcare will be a disaster for essentially every one of my patients, including my self and my wife, as we all have pre-existing problems. If you are young and healthy you will be able to buy a relatively cheap policy. But, buyer beware, as to what you will actually get. As for the rest of us, be prepared to pay a lot more or to be placed in a high-risk pool, which was in the past terrible for the patients, but great for the insurance companies. Even if you are healthy and 60 years or older be prepared to pay up to 67 percent more for your insurance than what you pay under the Affordable Care Act.

I have contacted my U.S. Congressman Jason Lewis, State Sen. Goggins and State Representative Drazkowski in the district in which I live, and I have contacted State Sen. Miller, and State Representative Pelowski in the district in which I have my office, about the health care issue. Representative Lewis has sent multiple form letters about allowing the free market system to work in the health care market (like that worked before the ACA), and that he valued my input. Unfortunately he never once answered any of the questions I posed to him.

Representative Drazkowski has never bothered to contact me back. Representative Pelowski sent me a card saying that I live in Rep. Drazkowski’s district, and that I should contact him on this issue. When I explained to his staff that my office has been in his district since I opened it in 1999 they said they would pass that on to him. Nothing yet!

Senator Miller’s assistant called and left a message but we have yet to make phone contact. The only one to actually contact me and discuss the issue was Senator Goggins. I thanked him and I applauded him for taking the time to talk to me.

Instead of throwing all of the money to the insurance companies for insurance that people can’t afford, it is time for a Medicare for all type of single-payer system. Health economists from all over the world almost universally say the two biggest reasons we have the most expensive health care in the world is: one, we are the only advanced country in the world where for-profit insurance companies are allowed to run the marketplace (ie. profit motive); and two, we have the most complex health care system in the world with thousands of private insurance companies, and dozens of state and federal programs. In my practice, I deal with 25-30 different insurance carriers every year. Each and every one of these programs have different rules, regulations, formularies, etc. So you can see what is being done in both the state and federal level is not helping decrease either one nor two, and will in all probability make things worse.

A single-payer system would be cheaper by taking out the profit motive and decreasing the complexity by only having one place to bill, as well as combining all of the other government health care programs into one. It would encourage physicians to enter the free marketplace and return to private practice by taking the complexity out of running an office. It would also decrease cost by spreading risk over everyone in the U.S. All 300 million-plus of us.

There would be no in or out of network, and patients would truly have the freedom to pick and choose their doctors, clinics, and hospitals. Finally, no one would ever go bankrupt over medical bills again. Presently hundreds of thousands of people go bankrupt over medical bills in the United States and most of these people start out with insurance. So, I ask you what service do the insurance carriers add to your health care? They appear to be nothing more than middlemen that extract massive amounts of money from individuals and taxpayers and in return impose rules and regulations to make it more extensive and harder to access health care. Presently it is projected that $0.30-$0.35 out of every dollar spent on insurance does not go toward health care, but for administration costs, marketing, and a profit margin. Unlike private insurance which runs administrative cost typically in the 20-30 percent range, Medicare runs about a five percent administrative cost.

I run my own solo practice in Winona, Minn., and our family has had to deal with our own share of medical problems, including pre-existing problems. After all I have dealt with, seen, and read, I truly believe that a Medicare for all type program is the only way we can cover everyone in our nation, at a reasonable cost It is estimated that our nation would save around $400 billion per year with over 90 percent of all businesses and citizens saving money. When elected officials and lobbyist tell you how bad a single-payer health care system is, why is it that people on Medicare want to keep it and most people approaching Medicare age can’t wait to get on. I encourage everyone to learn about the different health care proposals. After learning about Medicare for all/single-payer system and you agree with me, then start contacting your elected officials. If they refuse to listen to the facts about single-payer health care, then it is time to vote them out of office.

For a general overview of the different types of health plans in the world, I recommend the book “The Healing of America” by TR Reid. There are many sources of information on health care, and some of the ones I have used concerning single-payer health care are: Physicians for National Health Policy (PNHP), the Minnesota Nurses Association, The Land Stewardship Project, and the Minnesota Green Party. For everyone, especially if you are self-employed, or a CEO, COO, CFO, human resources manager, etc., I recommend the website Fix-It: Healthcare at the tipping point. This gives you a business perspective on heathcare, concerning a single-payer health care system. If anyone has any questions, would like more explanations, or a presentation on single-payer health care, please contact me at markmartindo@gmail.com. My office address is 350 East Sarnia Street, Winona.